KELLEY E BANAGAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036125389

License Status

NOT RENEWED

Business

First Name

KELLEY

Middle

Last Name

BANAGAN

Suffix

Business Name

KELLEY E BANAGAN MD

Original Issue Date

04/05/2010

Effective Date

04/05/2010

Expiration Date

07/31/2011

City

BALTIMORE

State

Zip

21230

County

MARYLAND

Ever Disciplined

LastModifiedDate

11/14/2011